With the onset of the COVID-19 pandemic in 2020, the federal government issued billions of extra dollars to Medicaid programs across the country to ensure Americans had health insurance during the worst public health emergency in memory. In exchange, state Medicaid programs were required to pause redeterminations. But as redeterminations resume, those who no longer qualify for Medicaid will be forced to find new health insurance or risk being uninsured altogether.

The first of the rolling renewal notices will arrive in early May. Officials from Illinois Department of Healthcare & Family Services, the agency which oversees Illinois Medicaid, previously told Crain’s it is doing everything it can to help eligible beneficiaries maintain coverage.

Now, Pritzker’s administration is hoping to support that work with “Ready to Renew,” a multi-platform outreach campaign that includes paid advertisements, print, digital and broadcast communications to educate Medicaid customers on coverage renewal.

“Now that pandemic-era protections are ending, we are making sure every eligible Illinoisan has the information they need to renew their coverage—whether they’re watching TV, reading the newspaper, riding the bus to work, or listening to their favorite radio station,” Pritzker said in a statement.

Pritzker’s office said the most important step Medicaid customers can take to claim a renewal is to provide their current address to the state. HFS has also created what it’s calling a Ready to Renew Toolkit, which explains how to navigate the redetermination process.

Throughout the COVID-19 pandemic, as redeterminations were paused, Illinois Medicaid grew to cover around 3.9 million people, up from 2.9 million before the pandemic. As of 2021, Illinois’ uninsured rate sat at 7%, according to the United Health Foundation. That’s down from 7.4% in 2019 but still higher than a low of 6.5% in 2016.

Illinois is not alone in the upcoming Medicaid coverage cliff. About 15 million individuals nationwide are expected to lose Medicaid in their respective states once the provision ends, according to federal estimates. Officials expect those who lose Medicaid to turn to employer-sponsored health insurance plans or those offered on the Affordable Care Act marketplace.

Aside from sparking a scramble for Americans to find new insurance, the changes to Medicaid could also strain hospitals and other health care providers, particularly safety nets and federally qualified health centers, which often treat many patients on government insurance programs.

Additionally, health insurance plans that administer Medicaid plans, such as UnitedHealthcare, Centene and Aetna, stand to lose money if the number of Americans they insure drops. The challenge for them is converting former Medicaid enrollees into paying plan customers.